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Pharmacology > Part 8-1 Cardiovascular Pharmacology > Flashcards

Part 8-1 Cardiovascular Pharmacology Flashcards

1
Q

Cardiovascular meds

A

Largest area of pharmacology

Meds often “wear several hats” and have multiple implications

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2
Q

Diuretics

A

Act on kidneys: increase sodium and water excretion

Decrease fluid in vascular system

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3
Q

Diuretics Indications

A

Hypertension

Congestive Heart Failure

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4
Q

Diuretics Examples

A

Thiazides
Loop Diuretics
Potassium sparing agents

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5
Q

Diuretics Adverse effects

A 
Fluid depletion; electrolyte imbalance
Watch for:
-orthostatic hypotension
-weakness, fatigue
-confusion, mood changes
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6
Q

Beta Blockers

A
  • Bind to heart to block effects of epinephrine and NE
  • Decreased HR & contraction force
  • Can also produce general decrease in sympathetic response
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7
Q

Beta blockers indications

A 
Hypertension
Angine
Arrhythmias
Heart Failure
Recovery from MI
Migraines
Raynauds
Situational Anxiety
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8
Q

Common beta blockers

A

“olol” suffix

Cardioselective and Nonselective

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9
Q

Cardioselective beta blockers

A

Atenolol
Metoprolol
Others

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10
Q

Nonselective beta blockers

A

Pindolol
Propranolol
Others

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11
Q

Beta Blockers adverse effects

A

Bronchoconstriction
Decreased maximal exercise capacity
Orthostatic hypotension
Psychotropic effects

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12
Q

Sympatholytic effect

A

A general decrease in sympathetic responses

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13
Q

Other sympatholytic antihypertensives

A
  • Alpha blockers
  • Presynaptic adrenergic inhibitors
  • Centrally acting agents
  • Ganglionic blockers
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14
Q

Vasodilators

A

Act directly on vascular smooth muscle…inhibit contraction

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15
Q

Vasodilators indications

A

Hypertension

Heart failure

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16
Q

Vasodilators adverse effects

A 
Reflex tachycardia
Orthostatic hypotension
Dizziness, headaches
Edema, fluid retention
Avoid systemic heat
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17
Q

Renin-angiotensin system

A

Neuroendocrine response that helps control BP and other physiological reactions in various tissues

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18
Q

People with excessive RAS responses have….

A

Increased blood pressure
Damage to CV system
Damage to kidneys

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19
Q

Options to prevent harmful effects of Angiotensin II

A
  1. ACE inhibitors
  2. Angiotensin II receptor blockers
  3. Direct renin inhibitors
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20
Q

Angiotension converting enzyme inhibitors (ACE)

A

Inhibit angiotensin converting enzyme

Decrease formation of angiotensin II

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21
Q

ACE inhibitors effects

A

Decrease BP and long term heart and BV effects

22
Q

ACE inhibitor indications

A

Hypertension

Heart failure

23
Q

Ang-II receptor blockers

A
  • Block Ang-II receptors
  • Prevent detrimental effects of Ang II
  • May be as effective as ACE inhibitors but fewer side effects
24
Q

Direct renin inhibitors

A

Aliskiren: inhibits renin’s ability to convert Angiotensinogen to Ang I

25
Q

RAS drugs adverse effects

A

Well tolerated, some nausea and dizziness
Possible allergic reactions
ACE inhibitors cause dry cough

26
Q

Calcium channel blockers

A
  • Limit calcium entry into vascular smooth muscle and cardiac muscle
  • Promote vasodilation, stabilize HR
27
Q

Calcium channel blockers indications

A

Hypertension
Angina pectoris
Arrythmias

28
Q

Calcium channel blocker examples

A

“ipine” drugs

29
Q

CCBs adverse effects

A 
Swelling in feet, ankles
Orthostatic hypotension
Altered heart rate
Avoid systemic heat
Increased risk of heart attack
30
Q

Organic Nitrates

A

Nitroglycerin, isosorbide dinatrate

31
Q

Organic nitrate route of administration

A

Sublingual traditionally

Creams or patches transdermal

32
Q

Organic nitrates primary indication

A

Angina pectoris

33
Q

Nitrates primary effects

A

Dilate peripheral vasculature

Decrease cardiac workload and O2 demand

34
Q

Venous dilation causes…

A

Decreased cardiac preload

Blood returning to heart

35
Q

Arterial dilation causes…

A

Decreased cardiac afterload

Pressure heart pumps against

36
Q

Nitroglycerin onset and duration

A

Sublingual:
1-3 min onset
30-60 min duration

Patches:
40-60 min
8-24 hr

37
Q

Isosorbide dinitrate onset and duration

A

Oral:
20-40 min onset
4-6 hr duration

Sublingual:
2-5 min onset
1-2 hr duration

38
Q

Isosorbide mononitrate onset and duration

A

Oral:
30-60 min onset
6-8 hour duration

39
Q

Amyl nitrate onset and duration

A

Inhaled:
30 sec onset
5-10 min duration

40
Q

Nitrate tolerance

A

Continuous adminstration reduces drug effects

Effectiveness restored quickly when nitrates are discontinued

41
Q

Prevention of nitrate tolerance

A

Daily nitrate-free intervals

Patch 12 hr on/12 hr off

42
Q

Nitrates adverse effects

A 
Headaches/Dizziness
Orthostatic hypotension
Increased vasodilation
Sublingual doses:
-check drug viability
-have drug ready before rehab
43
Q

Digitalis

A

Group of agents derived from foxglove plant
-Digitalis glycosides
Used for congestive hart failure

44
Q

Digitalis mechanical effects

A

-Inhibits Na-K pump in cardiac cells; accumulates Na in cell
-Increases intracellular Ca2+
-Increased actin-myosin binding
(Stronger cardiac contraction)

45
Q

Digitalis Autonomic effects

A

Decreased HR by:

  • stimulating vagus
  • inhibiting sympathetics to heart
46
Q

Digitalis Toxicity

A
  • Relatively common 20-25% hospitalized patients on digitalis
  • Can be fatal
47
Q

Digitalis toxicity common symptoms

A 
GI distress
Fatigue
Confusion
Depression
Blurred Vision
Arrhythmias
48
Q

Positive inotropes

A

Acute or severe heart failure

  • phosphodiesterase inhibitors
  • Dopamine, Dobutamine
49
Q

Phosphodiesterase inhibitors

A

Increase myocardial Ca by preventing Camp breakdown

50
Q

Dopamine/Doputamine

A

Stimulate beta-1 receptors

51
Q

Positive inotropes limitations

A
  • Parenteral administration
  • Not more effective than digitalis
  • Typically used in acute or severe heart failure

Pharmacology (15 decks)

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